Residential Property Claims Guide

12 After listening to and discussing a consumer’s concerns over the phone, a Hotline officer may decide to send the consumer a Request for Assistance (RFA) form to be completed and returned to the Department. The RFA provides the necessary information to open a claims investigation, which will be handled by officers in the Claims Services Bureau. The primary function of the Claims Services Bureau is to investigate complaints and answer questions related to the handling of claims. This Bureau determines if insurance companies are fulfilling their lawful obligations to policyholders that file claims. The Department will determine if it is appropriate to send you an RFA for the Department's Residential Property and Earthquake Claims Mediation Program. This program is an informal, non-adversarial, and timely way to resolve a claim dispute with your insurance company. In addition, this program is free to the consumer (the insurer pays the fees). A detailed brochure describing the program may be obtained by calling the toll free number on the next page. In order for the residential property losses to qualify for mediation, they must have occurred after September 30, 2003, and the Governor must have declared the event a "state of emergency." • Consult an Attorney If you hire an attorney, provide him/her with a copy of your insurance policy and all other relevant documents. Get your attorney’s fee structure in writing before you give him/her your business. You will no longer talk directly with the insurance company, but can remain current on the progress of your claim by insisting that you receive copies from your attorney of all correspondence involving your case. Your attorney must have your approval before committing to any settlement.